GUATEMALA 
AN ADDRESS 
DELIVERED AT THE OPENING OF THE • 
CALIFORNIA STATE MEDICAL SOCIETY, 
APRIL 18, 1883. 
By the President, DR. L. C. LANE. 
M. R, Beard & Co.. Stationers, 4-24 J St., Sac. GUATEMALA. 
An Address delivered at the opening of the California 
State Medical Society, April 18, 1883. 
13Y THE PRESIDENT, DR. L. C. LANE. 
Believing the facts might prove of interest to the most of 
you, and add something to the knowledge of the medical 
topography of a region but imperfectly known, I herewith 
offer the following observations, recently made during a visit 
to the Republic of Guatemala. 
Guatemala is the most northern of the five States which 
geographically comprise the region known as Central Amer- 
ica; the remaining four being Salvador, Honduras, Nicaragua 
and Costa Rica. Guatemala lies between 14 and 18 degrees 
of northern latitude, and hence it is situated wholly in the 
tropics. Besides, it lies in the northern portion of that sin- 
gular constriction which the hand of Nature has impressed 
on a portion of the equatorial region of the western conti- 
nent, presenting a varying breadth of from three hundred to 
four hundred miles, between the Atlantic and Pacific oceans. 
South of Guatemala, the constriction becomes lessened in 
space until, at the Isthmus of Darien, it is but forty-seven 
miles wide. All old Californians remember the Isthmus, and 
carry in memory an unfading picture of a journey across it; 2 
Statk Mkiucal Socikty. 
and no matter how many shadows departing years may cast 
over us, this picture hangs untarnished in the background of 
our lives, and as we turn again to it, 
“ Where o’er hill and valley plays 
The sunlight of our early days,” 
I Hin sure there is awakened in each of our hearts an inde- 
finable thrill of pleasure. 
For recreation, as well as to escape the unpleasant season 
of mid-winter in San Francisco, on the 80th day of last 
Decemlier, accompanied by my wife, I embarked on hoard 
the steamer Granada, for Central America. Hi-monthly 
trips are made thither by vessels of the Pacific Mail Steam- 
ship Company. These vessels touch at two Mexican jiorts 
and four in Central America, finally arriving at Panama; 
thence they connect with a line on the Atlantic side, so that 
in this way the passage can be made from San Francisco to 
New York, the whole journey l>eing made in alsmt one 
month. On hoarding the Granada, I was struck with the 
wonderful difference in the accommodations of the present 
steamers and those of former times. The demands of com- 
merce have banished from use the magnificent side-wheel 
steamers, so well remejnl»ered by all who made this trip 
twenty years ago. Instead of a floating palace, where all 
was arranged to afford the highest comfort and luxury to the 
traveler, we were ushered al*oard a screw-propeller, where 
state-rooms are narrowed to petty closet-like quarters. 
Though these steamers are more comfortable than the famous 
Cuiiarders that cross the Atlantic, still they have but little to 
remind one of the sumptuous quarters which once floated on 
these waters, and still less to alter the definition which I>r. 
Johnson gave of a sea voyage, “ imprisonment, with the 
chances of lieing drowned superedded.” Though the voyage 
has been l>ereft of many of its olden attractions, still there Annual Address. 
3 
are some persons in whom the desire to hasten in life’s fever- 
ish struggle is so far absent that they prefer this way of 
reaching New York. It were well that more of our care- 
worn business men would take this journey when they re- 
turn to their old homes in the East; they would thus slow 
the hand that is measuring off the hours on the dial plate of 
their lives. 
Though our departure was in the season when storms 
usually lash our coast, still our steamer floated out through 
the Golden Gate in as smooth a sea as the most solicitous 
sea traveler could wish. As if to chronicle the approaching 
conclusion of 1882, the hour of sailing was shifted from 
morning till late in the evening; so that before we had 
reached the ocean outside, the sun was sinking in the watery 
horizon, and casting its last rays on the retiring city and the 
magnificent coast range of mountains which lie at the en- 
trance of the Golden Gate, and farther beyond encircle our 
Pay. Around Tamalpais floated those fleecy clouds which 
are so characteristic a feature of the landscape, and which as 
“phantom ships” have been so eloquently described by Pol- 
lock, one of California’s most gifted verse writers. How 
many argonautic adventurers of every profession and grade 
of humanity, including even the talented Pollock himself, 
after all their struggles in ,our new State, have in the end 
grasped nothing but gilded clouds, which proved cold and 
empty forms of hitter disappointment! 
The ocean that received us with so placid a face, in less 
than twenty-four hours assumed his proper wintry dress, and 
during the remainder of the voyage treated us to continu- 
ously rough weather, and on one occasion to a violent storm. 
Most persons who have gone to sea, afterwards have their 
storm-story to tell; and as the stories are much alike, I will 
omit the narration of mine, except to state that it was en- 4 
State Medical Society. 
countered in crossing the Gulf of Tehuantepec, which seems 
to l>e one of Nature’s great blow-pi |>es, through which is ex- 
pelled from the interior of Mexico a huge blast of wind that 
reaches far out into the Pacific Ocean. This region is so no- 
toriously the site of storms that every traveler who makes 
this voyage learns the fact from some older voyager long be- 
fore he reaches the place. From the mild blow that is gen- 
erally experienced in crossing the outlet of the Gulf of Cali- 
fornia, and the still severer one at the Gulf of Tehuantepec, 
it would seem that Nature has a sj>eeial love for blowing over 
a tongue of water that projects into the land. 
The storm off Tehuantepec tested the bottom of our 
steamer, as well as that of every passenger’s stomach; the 
former lost none of her cargo of the latter so much cannot 
be said. For over one hour, while the steamer was running 
l>efore the storm, two sharks kept near her keel; whether 
these heten»cercal monsters snuffed a Inuiquet ahead, or 
whether idle curiosity impelled and sustained their diligence, 
remained an unsolved problem, yet they did prove one thing: 
that muscle and tin can make as much progress in water as 
steam. Another observation made was that the phosphores- 
cent agent in a calm, when the water is moved diffuses itself 
like liquid tire—but during this storm the luminous principle 
seemed to aggregate itself in isolated centers, so that the 
amount of light emitted was lessened. 
In llyrtl’s To|»ographieal Anatomy —a ls*>k in which the 
student will learn much anatomy and lie entertained with 
much that is witty, quaint and sparkling the author tells us 
how, in crossing the Mediterranean Sea, he spent his time in 
studying the action of the alKlomiual muscles in the act of 
vomiting. If Hyrtl had been a voyager on this passage and 
shared the fate of most of those on ls*ard, I am certain that 
paragraph in his Anatomy would not have been written, since Annual Address. 
5 
both his head and his stomach would soon have been empty. 
Many attempts have been made to offer a scientific expla- 
nation of sea-sickness; to the numerous ones found among 
medical writers, 1 will add one more: 
In the last few years the German cerebro-vivisectionists 
have plainly demonstrated that in many instances of cerebral 
trouble the cardinal condition is that of anaemia, instead of 
hyperaemia, as was formerly taught, and as the concomitant 
of such anaemia, nausea may arise in a perfectly sound stom- 
ach. In intra-cranial circulation two factors figure— the 
movement of the blood and the movement of the cerebro- 
spinal serum. The affluent blood-wave displaces and causes 
the serum to escape from the skull; the returning blood-wave 
again acts reversely, and, as it escapes, it is replaced by the 
entering, cerebro-spinal serum. Such efflux and reflux of the 
serum can he seen in the animal’s neck, when the occipito. 
atloid ligaments are laid bare. The ascent and descent of the 
o 
subject on shipboard tend to interrupt the uniform move- 
ment of the reciprocal currents—both by virtue of their in- 
ertia sink as the vessel rises, and rise as the vessel sinks; 
thence arises disturbance in the equilibrium of the supply of 
blood to the brain, and, as a further consequence, sympathetic 
nausea. Long continuance of the cause finally begets a tol- 
erance, and hence a disappearance of the sea-sickness. Should 
this explanation share the fate of its predecessors, and require 
that non sequitur should he appended to it, let the discoverer 
of the fallacy refrain from concluding,propter inscitiam pro' 
priarn—(lack of individual experience.) 
To get relief, or in a measure to avoid sea-sickness, secure 
a berth “amidships,” and during rough weather maintain the 
horizontal position, use a light and- easily digested diet in 
which there is no excess of liquids, and remain in bed during 
the period requisite for digestion. As constipation sooner or 6 
Statk Medical Society. 
later occurs, thin should be relieved l>y proper remedies; and 
this hitter hint should especially lie attended to at the end of 
a protracted voyage where there has been a transition from a 
cold to a hot climate. This little precaution, and especially 
if the traveler will take old Kush’s “ten and ten” of submit- 
riate and jalap, will often ward off an attack of fever. Sea- 
sickness, depending as it does upon causes outside of the 
lxsly, is not curable by any internal remedy. Chapman’s 
ice-bag, with which many English travelers provide them- 
selves when they cross the Channel, nitrite of amyl, the bro- 
mides, etc., are all useless ballast in a sea voyage. 
The lines of Byron— 
"Of all the wo* the traveler pukea in, 
None is more dangerous than the Kuxine,” 
plainly point to the universality of sea-sickness; ami he who 
travels by sea may safely include this in the expenses which 
he must incur in order to see other lands, for none are exempt 
except a favored few—very few—in whom the jwrtial hand 
of nature has so cunningly adjusted the elements of the cere- 
bral circulation that they never get adrift, but remain rhork-a- 
klock during wind and storm. 
During our progress southward we were generally in view 
of land; the western coast of Mexico, consisting of hills and 
low mountains that were nearly destitute of trees and living 
vegetation, made a landscajK* of which the eye seldom grew 
weary’. And this view lieeame doubly interesting when it 
reminded one, as was often the case, of the Coast 1 hinge of 
mountains of our own State, and recalled those picturesque 
lines of beauty which nature has so happily traced in the 
face of California. As in art, one finds different schools with 
distinctly characteristic methods and styles, so in sketching 
mountain forms, uniformity has not fettered the hand of na- 
ture; such liberty she indulged in while tracing our coa*t Annual Address. 
7 
mountains and foothills, developing a style elegant, distinc- 
tive and peculiar. The mountain of Norway with its som- 
bre brow of pines mirrored in the lake at its foot, and the 
Alpine peak with the green meadow at its base bestarred 
with yellow flowers, have each their special charm—yet the 
traveler who has not seen the mountains of California has 
yet in store for himself a pleasure which the former can 
never awaken in his heart. And this same originality of 
character is found from the Columbia liiver to the tropical 
region of Mexico, reappearing again, as I have seen in the 
Andes of Peru. Hence the Sierras, the Cordilleras and the 
Andes are one and the same sketch made by the hand of Na- 
ture—a sketch in which the devices of concealment with 
which Art often disguises her defects are rigidly avoided, since 
each outline is distinctly traced on the sky, and is as clearly 
visible as if seen in a miniature picture held in the observer’s 
hand. 
On the eleventh day of our voyage we arrived at Chani- 
perico, a small port on the coast of Guatemala. Champerico 
has commercial importance on account of the large amount 
of coffee produced in its vicinity and thence shipped. From 
this point the two distinctive physical characteristics of the 
State of Guatemala become plainly visible, viz: high lands 
and low lands. The low lands comprise a highly fertile belt 
of soil that reaches some thirty miles inland from the Atlantic 
and the Pacific; between these level plains lies the high land, 
which rises here and there into mountains of high altitude. 
The greatest elevation reached is between two and three miles 
above the sea level. Among the summits that especially at- 
tract notice are those of Santa Maria, El Agua and El Fuego, 
the latter two being volcanoes which have not lost their func- 
tion of occasionally disgorging their fiery contents. 
During our stay at Champerico several of the travelers 8 
Static Medical Society 
were entertained by an excursion upon a short portion of the 
railroad that is l>eing constructed from the jh*rt to a town 
which is situated alxmt thirty miles inland, and when finished 
will serve as an outlet to the immense crop of coffee grown 
in that region. The passengers who enjoyed this short ride 
were quite carried away in their transports of wonder at the 
tropical scenes which were thus suddenly opened to their 
view; and I am sure that each one hears with him many kind 
remembrances of the hospitalities of Captain Douglass and 
others who are managing the construction of this road, which 
is being built by the money and enterprise of a San Fran- 
cisco company. 
From Champerico, a few hours steaming brought us to San 
Jos6, the leading port on the western coast of Guatemala. 
Here, as the early morning opened, we found ourselves lying 
almost in the shadows of the volcanos, Water and Fire, which, 
though some miles inland, seemed very near, owing to the 
clearness of the air. From the nostrils of El Fuego (tire) a 
cloud of white vapor was slowly escaping and idly wreathed, 
like grey locks, this slumbering Titan’s head. As he lay 
there in his placid sleep no one would have thought that in 
that quiet form were concealed the earthquake and Force and 
Might, more than a match for Promethean divinity. 
The tumult and bustle consequent ujkmi disembarking are 
illy consonant with the musing which otherwise such a morn- 
ing and such scenery might have favored; thoughts of a more 
practical nature occupied our minds, viz. to go ashore and 
see that none of our effects were left behind. From the 
steamer we were carried in barges to the end of a long iron 
pier, which has been built from the shore into the water about 
one-eighth of a mile. 
To digress here. Nature has lieen very unequal in her 
gifts to the eastern and the western sides of the continent Annual Address. 
9 
The eastern coast has been favored with well sheltered har- 
bors—great pockets, as it were, inviting commerce to shelter 
there its stores. The Pacific side, on the contrary, is remark- 
ably wanting in such resources. Any one wdio has easily 
walked on or off a vessel lying at one of the wharves of San 
Francisco, and who debarks at a Mexican, Central American, 
or South American port, in a small boat that is compelled to 
land on a harborless, unprotected beach, has learned that our 
land-locked bay is a natural gift beyond all price. And these 
advantages will take a still higher rank, if he should ever 
land at San Jose de Guatemala, where the debarkation is done 
in a basket that is suspended to a crane some twenty feet 
above. The hoisting of the basket and its swinging shore- 
wards are done by steam. The tossing of the small boat 
which carries him to the pier, and-the swaying revolutions of 
the balloon-like basket, for the first hour of his advent, will 
quite absorb his attention. 
Among the fellow passengers during the voyage was Gen- 
eral Butterfield, a man well known in the history of our 
country as a fearless champion of the cause of our Govern- 
ment during the late war. His present mission hither was 
as the representative of, and shareholder in, an American 
company that has purchased the control of a railroad which 
has lately been constructed from San Jose to Escuintla, a 
town nearly thirty miles inland. General Butterfield, accom- 
panied by Mr. George Crocker, son of the well known capi- 
talist of San Francisco, came for the purpose of completing 
this road to Guatemala City, the point of its final destination. 
Besides this work, they are now occupied in making topo- 
graphical surveys preliminary to building other railroads in 
Guatemala, and the adjacent State of Salvador. The great 
energy, unusual powers of endurance, experience in the field, 
and personal ability of General Butterfield, and above all, his 10 
State Medical Society. 
self-denying devotion to the enterprise which has l»een dele- 
gated to him, shows that Northern capital has exercised keen 
discretion in the selection of its management; and if a pre- 
diction l>e allowed, it requires no special acumen to discover 
that the hand which led martial hosts to success in war, will 
conduct peaceful legions here to no less signal victories in 
their battles with tropical nature. 
On arriving at San Jos£, General Butterfield invited a 
number of the passengers to accompany him in an excursion 
from the port to Escuintla, t*he present terminus of the road. 
The strange novelty of the tropical Horn of the country trav- 
ersed by the road, many of the shrubs and trees being in 
bloom, and others l»eing quite covered with the rich flowers 
of the trailing convolvulus, was one of those rare spectacles 
which falls on the traveler as a new revelation, that remains 
sis an unfading picture forever sifterwards, giving delight sis 
often as the hand of memory unveils it. In that panoramic 
scene which was rapidly unfolded to view, as the train s|>cd 
on its course, were now and then caught glimpses of Helds of 
Coffee and sugar cane, and of the thatched huts of the Indians, 
under the shade of cocoa |>alms and orange trees. At Ks- 
cuintla, the party was the recipient of a choice collation, in 
which the wine of the North mingled its gift with that of 
the passion-flower and a half dozen other tropical fruits. 
This finished, the party next visited a church built over two 
hundred years ago, and ascending its half-ruined tower, looked 
on one of the most l>eautiful landscapes of Guatemala- a 
scene which the artist's pencil, not written words, can por- 
tray. Thirty miles away lay the Paciflc, of which the mov- 
ing waters, mirror-like, gave glimpses of reflected light; 
while nearer by, cloud-shadow and sunlight disputed domin- 
ion over vast scopes of evergreen forests and fields, whose 
verdure rejoiced in unending Summer; on the other side, Annual Address. 
11 
close at hand, rose the huge forms of Water and Fire, tlieir 
bases enriched with a zone of forests, interrupted now and 
then by cultivated fields of cane and coffee ; these green 
fields could he descried reaching far up toward the summit, 
and seemed to hang, like emerald gems, on the mountain’s side. 
In the evening, after the rest of the party had returned 
aboard, we drove to the plantation of Concepcion, which lies 
at the base of the volcano of Agua. This large estate, 
which is devoted to the raising of sugar cane, is the property 
of Baron Duteil, who came to Guatemala many years ago. 
This place, which is in a high state of cultivation, besides its 
wonderful natural endowments, shows in the rare felicity of 
its improvements that its owner has kept even pace with 
nature ; for one is surprised at the rare combination of com- 
fort, luxury and elegance which blend in the appointments 
of its manorial mansion. From Escuintla, there leads to it 
an excellent road, the latter portion of which passes through 
an alameda or avenue of cocoa palms, bordered on each side 
by a broad expanse of sugar cane, all of which was overlooked 
from the cool piazza of the front of the house. In the rear 
was another open piazza where meals were served, and where 
long vistas of field, forest, gorge and volcano, took the place 
of the ordinary wall pictures. A third side looked on a 
fountain of playing water and on a short avenue of trees that 
ended near a swimming bath. This bath was constantly re- 
plenished by pure water from a neighboring stream, the 
water constantly falling, cascade-like into a stone reservoir 
some thirty feet long, that was overarched by a bower of 
roses and passion flowers; the perfume of these flowers, and 
their tints yet visible in the moonlight, the faultless tempera- 
ture of both air and water, made a picture of oriental luxury 
such as will recall to the reader’s memory Irving’s sketches 
of the Alhambra. 12 
Statk Mkiju ai. Socikty. 
The amount of sugar produced at Concepcion was so enor- 
mous that u]K»n tiie item of spirits distilled from the waste 
material the government receives a tax of over live thousand 
dollars a month. 
Leaving Concepcion on the following day, we next pro- 
ceeded to Barcenas, a large coffee estate that lies somewhat 
olf the main road which leads from Escuintla to the City of 
Guatemala. This place is owned hy Sehor Samayoa, who is 
the Minister of Agriculture, and is reckoned among the 
wealthiest men of Central America. Our late arrival pre- 
vented us from seeing much of the estate that night, hut 
early the next morning the most of the party were on the 
grounds, eager and curious to see growing coffee. One saw 
there this precious shrub in ever)' stage of growth, from the 
nursery plants, which were just [jeering through the earth, 
under cover to screen them from the hot sun, to the full grown 
shrubs, some ten feet high, which were laden with nearly ripe 
fruit. This shrub resembles somewhat a cherry tree in foliage, 
though the leaves are more glossy. The fruit grows in 
crowded clusters, without stems, in the axils of the branches. 
Each l>erry, when ripe, is of purplish tint, and if perfect, it 
contains two hemispherical grains with their flat faces op- 
posed. The pulp of these berries is of a sweetish taste, and 
possesses none of the qualities of coffee. From the growing 
shrub we were next corn!ucted by Mr. Klee, the manager of 
the estate, to the mill where the coffee berries were l>cing 
hulled or threshed. During the short time that we regarded 
this work, several hundred [jounds of coffee [wished through 
the mill. The consuiuerof coffee in the North will value his 
cup still more when ho learns that the annual product of a 
shrub is never over four pounds, and on an average is not 
much more than one pound; that the producing period of a 
shrub is not more than fifteen years; and that each grain of Annual Addkess. 
13 
coffee, from planting until it reaches the sack, receives the 
labor of over a dozen persons. The coffee which commands 
the highest price in the market, known as the pea coffee, but 
here called “ caracolillo,” from its resemblance to a- snail 
shell, is of small, round form, like a miniature egg, and would 
appear to be a dwarfed product, where the berry, instead of 
two grains, contains but one grain. 
From Barcenas we proceeded to the City of Guatemala, 
the first hour’s ride being through coffee fields belonging to 
the estate of Samayoa. In many places I observed that the 
shrubs were partly shaded by the plantain or banana shrub. 
After some four hours ride we reached the City of Guate- 
mala, situated on a large plain about one mile above sea level. 
'On arriving here nearly all persons are rendered sensible of 
the high altitude through the increased demand made by the 
lungs for more air, owing to the rarity of the atmosphere. 
The City of Guatemala was originally built about thirty 
miles from the present location, close to the base of the vol- 
canos, Water and Fire, and at a slightly less elevation than 
that of the new city. The old city, now named Antigua, was 
twice destroyed by the adjacent volcanoes—once in 1541, and 
again in 1762. In the first disaster, on a dark night when 
rain was rapidly falling, there gushed forth a flood of water 
from one of the mountains, which was quickly followed by 
an eruption of lava from the other; and these destructive 
forces were soon reinforced by earthquakes, so that the town 
was utterly destroyed, burying in its ruins the families of 
Alvarado and others of the primitive conquerors. The old 
Castilian conquerors, shrinking from no peril and dismayed 
by no disaster, rebuilt the city, to suffer a similar fate from 
earthquakes two hundred and twenty years later. 
A visit to Antigua shows the traveler a wonderful pile of 
ruins, surpassing anything of the kind to be seen elsewhere State Medical Society. 
14 
in America. I saw there the fallen, or half fallen walla of 
over one hundred and fifty churches, of which enough re- 
mained to show their former greatness. Walls cleft and 
partly or wholly fallen, fragments of broken columns, ruined 
arches, broken statuary, fallen altars, shrubbery and trailing 
vines disputing with mutilated figures for place in the weather 
stained niches, and leasts stabled on floors where once the 
worshiper knelt, are the characters in which the earthquake 
and volcanic violence have left record of their advent of ruin. 
The country around Antigua is of unsurpassed richness. 
As in the fertile fields around /Etna and Vesuvius—so here in 
these volcanic crucibles Nature has compounded a soil most 
favorable to vegetable growth; here the coffee shrub bends 
under its richest harvest, and fruit trees so numerous that 
their names would till a half |>age, with slight toil offer their 
luscious products to man; here all plant-life revels in riotous 
luxuriance. No wonder that in such an Eden numerous 
warnings passed unheeded; and only when the demon of 
destruction had converted the place into one vast tomb did 
the inhabitants forsake this (Kinidise and lest there should 
l>e a return thither, the fallen city is more securely guarded 
than if sentineled by a flaming sword turning every way at 
its gates, since not a week passes there without an earthquake, 
nor a day without some tremor, as revealed by the sisometer. 
The present City of Guatemala contains sixty thousand in- 
habitants, ami is located on a large plain that is surrounded on 
the east, north and west by ranges of mountains. When the 
city is looked at from an eminence it presents a very impos- 
ing appearance, owing to the walls of the houses being of 
snowy whiteness and many of the churches being models of 
architectural l>eauty. The streets, crossing at right angles, 
are of good width and paved with atones of two forms—one 
of flat blocks, placed at regular intervals, while the other, Annual Address. 
15 
smaller and more irregular, fill the spaces between the blocks 
—and the whole is so disposed as to slope towards the center 
of the street, there forming a shallow gutter. The sidewalks, 
sloping towards the street, are paved with square blocks of 
stone. The city is provided with a system of sewerage which, 
though imperfect, is superior to that of San Francisco. 
To digress to the important topic of sewers, I would here 
say, that when abroad a few years ago, I made a careful and 
laborious examination of the sewerage system of London, and 
from the Board of Works of that metropolis procured draw- 
ings and description of the same; also, a description of the 
Paris system; all of which is contained in a biennial report 
of the California State Board of Health. An examination 
and comparison of the system of San Francisco with that of 
London or Paris convicts us of egregious ignorance and stu- 
pidity, and will cause every lover of our city to wish that he 
he could blot out this page from the municipal history of San 
Francisco; yet, so long as official position, votes, and sewer 
builders and cleaners are so closely articulated, so long will 
mismanagement prevail and epidemic pestilence make its re- 
current visitations. 
The houses of Guatemala are built of adobe, stone, or brick, 
the walls being from two to three feet thick, to afford security 
of escape in case of earthquakes. To have sufficiency of 
room, they must occupy much more space than even large 
houses do with us. The floors are made of half-burnt brick, 
resting on a concrete foundation, and are covered with a thin 
straw matting. One great pest of the country is fleas, which 
are not confined to the untidy houses of the poor, hut they 
hold sway in every household. While Nature has added to 
the size of other insects in the tropics, she has amply com- 
pensated for diminished volume of the flea by increased ac- 
tivity, and, as if to favor this commonwealth of insects, men- 16 
Static Mkdical Sooibty. 
tha pulegium has l>een omitted in the Horn here. I would 
advise one of those enterprising Dalmatians who are growing 
flea powder in the neighborhood of Stockton, California, to 
come here and plant the flea-driving pyrethrum. If he will 
do so, he will enrich himself, and win the praise of this flea- 
ridden people. 
The water used here comes through time-worn and rickety 
aqueducts, from a natural fountain, some miles distant. 
Arriving in the city it is conducted to one or more reservoirs 
in each block, which are constructed in a corner or side of a 
house, in which the rattling sound of the falling water is 
heard, as one passes near it. From such a reservoir, several 
houses are supplied. The water, before its use as drinking 
water, is caused to pass through the porous waif of a large 
filter that is made from tufa or volcanic rock. Besides 
cleansing, this stone Alter cools the water. Such filtration 
might l>e adopted with advantage in San Francisco. 
As public institutions for the indigent sick, one finds two 
in the City of Guatemala, one for soldiers, and the other for 
civilians. Through the courtesy of Dr. Joaquin Vela, I was 
enabled to see and inspect each; also from his annual rejs»rt 
I was able to get much information respecting hospital man- 
agement here. 
The Military II ospital is located on elevated ground, three 
miles from the city. The diseases seen there were those re- 
sulting in the main, from dissipation, the largest contingent 
l»eing furnished by the Guard of Honor. One found that 
the Southern sons of war are nearly akin to those of the 
North, in making frequent pilgrimages to an unlawful 
shrine; and as Vulcan caught in a net the war god during 
an unlawful visit to his own household, so the followers of 
Mars often re-enact his role, insomuch that their foil a* cost 
the State as much as their wounds in its defense. Hygienic Annual Address. 
17 
philanthropy has here a hard problem to solve. Who has 
the wisdom to do it? 
A visit to the Hospital General for civilians showed me an 
institution as well conducted as similar ones in the United 
States. Disease here is classified as internal, or medical, and 
external, or surgical; and each of these sections is under the 
charge of an intelligent corps of medical attendants. ’The 
whole number of patients treated here during the year 1882, 
was five thousand four hundred and ninety persons; of these 
there remained on hand January 1st, 1883, two hundred and 
forty patients; whole number of deaths in 1882, four hundred 
and thirty-three. The medical and surgical service is rendered 
gratuitously, with the permission of the service utilizing the 
hospital for medical instruction. Internes, chosen by the fac- 
ulty of the medical school, reside in the hospital, and to some 
extent replace the regular physicians during their absence. 
The physicians and surgeons attending the hospital are mainly 
graduates of the Guatemala school, who have been abroad 
and added to their qualifications by a period of study in 
Paris. 
In the treatment of the sick, Dr. Yela told me that they 
had abandoned the use of stimulants. This course had been 
adopted after a trial of Todd’s mode of treatment by stimu- 
lation, under which it was found that more died than under 
the present non-stimulant method. 
A striking feature in the building is that the main portion 
of it is constructed in the form of a Greek cross; the effect 
of such an arrangement is singularly impressive, as, standing 
in the center the eye wanders along the four avenues, each 
lined with two rows of beds for the sick. Suffering in its 
many forms seemed strikingly in place there, and to re-enact 
the great scene whence sprang this sacred symbol, which 
devotion and self sacrifice have carried to every clime and 18 
Static Mkihcai. Sooikty. 
planted on every allure wliere throbs a hnnmn heart. 
Tlie immediate attendance upon the patient* i* rendered 
hy Sisters of Charity; and to thia ia due the remarkable 
order, the acrupuloua cleanliness and the fan 1 ties* ayatem 
which characterized the internal management of thia inatitu- 
tion. A large range of observation, embracing nearly all 
part* of the glolie, ha* proven to me that such management 
ia the best, and it ia quite inexplicable why the French 
authorities have lately become bo hostile to it, and are ao 
determined to abolish it. Armand Despres, of resolute heart 
and great readiness aa a writer, firmly resist* thia change in 
the Parisian hospitals, and though in the minority, lie ia 
giving his opponents much trouble. Besides observation 
abroad, personal experience at home, while acting as surgeon 
to a hospital in San Francisco, under the care of the Siatera 
of Mercy, has fully proven to me the excellence of thia aya- 
tem, for .one sees that untiring devotion to the wants of the 
sick, utter extinction of seif, and final death at the altar at 
which an unchangeable purpose had l»een pledged, find there 
their fullest realization. 
The source* of maintenance of the Hospital General are 
novel and worthy of mention. These are moneys derived 
from the sale of lots for the burial of the dead, income from 
bull tights, a lottery established for this purpose, a certain 
jiercentage of l>equeat* left by will, also bequests occasionally 
made to the hospital, and a jiart of the collections made in 
the churches. 
The burial of the dead is under public management, and 
is an expensive matter, coating those of average mean* from 
five hundred to one thousand dollar*. The interments are 
made a few hours after death. The Ixsly is dejioaited in a 
stone or brick receptacle that ia on a level with the earth, 
while about this there is built a somewhat pretentious mauao- Annual Address. 
19 
leu in of brick or stone masonry. And these houses for the 
dead are of snch uniform similarity, that when one lias seen 
one, lie lias seen the whole. The old cemetery is now nearly 
full of such vaults. 
In a part of the burying grounds, there is a portion sepa- 
rately walled off, over the entrance to which is the inscrip- 
tion, “ Creencias Varias,” meaning, “dissenting creeds.” 
Here one finds a number of vaults containing the bodies of 
those who, wandering to this remote land in quest of fortune, 
have found a tomb instead. On reading the inscriptions, 
one learns that these unfortunates have wandered hither from 
almost every country of the Protestant North. As a rule, 
Art has given them tombs of more simplicity, and absent 
Friendship places fewer yotive offerings thereon than one 
finds over the graves of their Catholic brethren. Yet for the 
absent wreath and cross, Nature has made amends, in replac- 
ing the one, by the trailing passion flower, and the other, by 
rearing one constructed of stars, in the Southern sky, for the 
Southern Cross, as a faithful sentinel, nightly watches their 
ashes. 
The largest sum of money derived from any source is that 
received from the hospital lottery. This mode of raising 
money, which would awaken scruples with many of us, is here 
regarded as strictly legitimate. Since I have been here the 
hospital has received the proceeds of a concert in which there 
were two hundred players on wind instruments. But of all 
the means of amusement whence money is procured for hos- 
pital support, the most famous is bull fighting. As this is a 
national entertainment of the Spanish, I am glad to be able 
to furnish a description of what I saw of it. There is a 
special amphitheater here for this diversion, where standing 
room, plain or choice seats may be had, according as the vis- 
itor is willing to pay. The central arena is fenced off by a 20 
Statk Mkdical SociktV. 
barricade from the spectators. Though this barricade is 
strong, yet a few weeks prior to my visit a bull broke it 
down, and added to the fete by tossing some of the spectator*. 
From two to five thousand {ktsoiis witness the tights. An 
hour or two before the spectacle it is announced by a number 
of persons, dressed in a grotesque style, parading the streets 
with dancing and shouting. The show commences with music 
from an excellent band, among whom is one who plays iijh»h 
an instrument of aboriginal origin. This instrument resem- 
bles in sound that of the wooden pianist on Kearny street, 
San Francisco. A company of soldiers are drilled, and dirt- 
play evidences of good training. In one act there is an in- 
tention to represent and personate a party rapidly growing 
here that has as its ultimate purj*>ee the union of the five 
Central American States into one confederation. There next 
follow some creditable equestrian feats. ()ne rider is espe- 
cially a favorite, and as he appears your neighl>or at your side 
is sure to tell you that he is the l>est rider in Central Amer- 
ica. This prelude having concluded, the fighters of the bull, 
partly on foot and partly on horseback, take their (jositions 
for the combat. These men are dressed in colors calculated 
to madden theanimal. All lading ready, the gate opens, when 
to the sound of music the bull is ushered into the midst of 
his persecutors. He is first teased, enraged, and chased by 
those on horse, who goad and annoy him in every possible 
way, taking care, however, not to seriously wound him. This 
is the most exciting and critical |>eriod of the show, since as 
soon as the bull is well maddened, he may make an unex- 
pected dash at a horseman, and throw both man and horse to 
the earth. Whenever the bull accomplishes this masterly 
feat, he follows it up by attacking the unhorsed rider. The 
first time I witnessed a fight this occurred, and for a moment 
the man was in extreme jeopardy; yet through the aid of Annual Address. 
21 
his comrades lie escaped, being more fortunate than a man 
who two weeks prior to this was so thrown and killed by the 
hull thrusting his horn through his chest. After a short time 
of chasing and teasing, during which the footmen flung red 
blankets in front of the bull, and paper-winged darts which 
fixed themselves in his sides, the animal became tired, and 
seemed to lose his spirit. As soon as he gave signs of this 
he was allowed to escape, and a new one allowed to enter. 
After a half dozen bulls are thus treated, in which, as a rule, 
neither man nor beast is much hurt, the show concludes by a 
bull being caught and haltered, when two men mount his 
back and ride him, to the infinite merriment of the specta- 
tors. In bull fighting as practiced here, no charge can be 
made of foiil play, since it is never permitted to kill the ani- 
mal, though that privilege is conceded to him; and should 
the latter catastrophe occur, most naturalists would agree that 
the great law of evolution would not be violated, since .there 
would be a survival of the fittest. 
From Dr. Yela’s annual report we learn that of the five 
thousand four hundred and ninety patients treated there were 
but sixty-three who had had tubercular consumption, and of 
these but about one-half had died. A striking difference 
from what one finds in England or in the United States; here 
deaths from tuberculosis amount to less than eight per cent, 
of all deaths, while in the North a large proportion of deaths 
in hospital practice is from consumption. Guatemala con- 
tains a population of one million and a quarter of inhabi- 
tants. Nearly half of these are Indians, the descendants of 
the aborigines who are civilized. The remaining population 
consists of Ladinos, who are a mixture of Spanish and In- 
dian, and, besides these, a small number of foreigners of vari- 
ous nationalities. Pulmonary consumption almost never 
occurs among the pure blooded Indians, but is chiefly found 
among the Ladinos. 
O 22 
Statk Mkdical Society. 
Goitre in of common occurrence, l>eing seen chiefly among 
the Indian women. As there is a prevalent opinion here 
that the cure of a goitre tends to develop scrofula, hence 
those subject to it seldom apply for treatment. Cretinism, 
closely associated with goitre elsewhere, does not occur here. 
The prevalence of goitre renders this a g<w>d place to test 
Chatin's theory in regard to the drigin of this disease. Ac- 
cording to him there is an absence of iodine in the water, 
air and food in regions where the disease prevails, and 
the general- absence of the disease is owing to the fact that 
the most of the world is daily taking, in'some form, a small 
dose of iodine, at least enough to retain its thyroid glands 
in decent limits. This subject is treated of exhaustively in 
Moleschott’s “Circle of Life,” and the reader of that section 
is surprised at the vast array of observations which the last 
twenty-five years has brought in support of this theory. 
In the vicinity of Guatemala there is a small colony of 
lepers, some fifteen in number, who are kept apart from the 
remaining po'pulation. The cases are found among Spaniards 
who are thought to be descendants of the Moors. The dis- 
ease consists of a hyj)ertrophy of the skin and the subjacent 
tissues, which finally ulcerate and slough. The disease is 
not considered to be contagious. 
Among those connected with the surgicrl service of the 
Civil Hospital Dr. Monteiros holds leading rank for learning 
and for ability as surgical operator. His recent return from 
a professional tour abroad was the subject of special com- 
ment by the daily press, as well as the occasion of an ovation 
on the part of his medical brethren. On the day of his re- 
turn several of his friends, as is the custom here, took car- 
riages and went out several miles to meet him. The ovation, 
however, had an abrupt and melancholy termination, in this: 
that one of the teams ran away and seriously if not fatally 
injured two medical students. Annual Address. 
23 
The Practice of Medicine is better fortified here against 
charlatanism than in the United States. No one can practice 
unless he is a graduate of a school of recognized standing, 
and then if that school he a foreign one, permission to prac- 
tice is only given to those who pass a satisfactory public ex- 
amination, and present a thesis written in Spanish, the whole 
costing the applicant about one hundred and fifty dollars. In 
passing along the streets here one is struck with the almost 
total absence of medical signs; and even if one is seen, it is 
in characters so small as to be illegible at a short distance. 
c> 
There is a medical school here that was founded many years 
ago. It is located in a picturesque building, one story high, 
and contains a large number of lecture rooms, among which 
was one very handsome apartment, for nse on public occasions. 
In the dissecting room I found tables much like those to be 
found in one of the medical schools of San Francisco. The 
number of the tables, as well as the receptacle for dissecting 
material, seemed quite inadequate to the wants *of one hun- 
dred students who are in attendance. The building is partly 
surrounded by a botanical garden, which, however, contains 
more ornamental plants than those used in medicine. The 
museum contains an excellent collection of specimens of nat- 
ural history—better than one would find in connection with 
any medical school in our country. So much however cannot 
be said of the pathological collection, which was sadly mea- 
ger. In the pathological museum one finds a rare example 
of a deformed infant, resembling closely that of Pitta, and 
Christina, in Buffon’s Museum, Paris. This child has a 
double head, one trunk, four arms, and four legs. Professor 
Meigs, of Philadelphia, never failed in his course of lectures 
to deliver an eloquent discourse on the Sardinian monster, in 
which there seemed to be duality of mind working in unison. 
The exhibition of Pitta and Christina brought money to the 24 
State Medical Society. 
parent*; hut this luckless Guatemaltecan died at hirtli, and 
its Indian father, believing its mother to be a witch, aban- 
doned her. 
Before admission to the medical school, the candidate must 
pass a satisfactory examination in the common branches of 
education ; lie must also jn*ssess some knowledge of the 
French, German, and English languages. A knowledge of 
Latin, once required as a prerequisite, has been dispensed 
with. This is singular, when one remembers the close rela- 
tion existing between medical literature and that language; 
and liesides, the Spanish is the most direct descendant of the 
old Roman tongue. The words of that ancient people, as a 
sacred heirloom, have been passed from lip to lip across the 
bosom of twenty centuries, and in many cases with slight 
change, except that in their transit they have acquired more 
precision ami harmony. So close is the kindred that if Livy 
and Ciesar were to ap]>ear in this picturesque land of the 
Cordilleras, they might readily fancy they were in a Roman 
colony. 
The curriculum of study here embraces the same subjects 
as in our schools; there is, however, far more time given to 
natural history and the physical sciences, but much less to 
pathology ami practical discipline. The curriculum embraces 
six years of al»out ten months annual study. As seen, the 
time of study exceeds that of England, France or Germany. 
As l»efore said, one finds two different climates in Guate- 
mala, the. one of the coast or low lands, which is intensely 
hot, and the intermediate high lands, in the midst of which 
the Capital is located, and where one finds a mild or cool 
temperature; and these physical differences lend their re- 
spective impress to disease, engendering fevers of extreme 
virulence in the low lands, while those of the higher plains 
have a milder type. An approximate notion of the tempera- Annual Address. 
25 
ture of the high lands may be formed from the following 
figures taken from a table of observations made by Mr. Mc- 
Nider, during his stay in the City of Guatemala: 
MORNING. 
NOON. 
EVENING. 
January 
68f° 
65° 
June 
63}° 
73° 
66f° 
Yearly average 
61° 
73° 
67° 
Mr. llall, resident American Minister, tells me that at 
midnight he has observed the thermometer to stand as low 
as fifty degrees. The average rainfall for the year is fifty- 
five inches. The rain commences in May and lasts for about 
six months, the largest fall being in September. Slight 
showers occur during the remaining so-called dry months. 
During my stay, which lasted from the 16th of January un- 
til March 16th, there were a number of showers. 
Owing to the unhealthfulness of the coast, wealthy land 
owners seldom live there; in fact, their visits there are brief 
and infrequent, knowing, as we 11 they do, that such visit is 
at the risk of life. On the contrary, they spend the most of 
the time in Guatemala City. During my stay in the city, 
Mr. I lam on Aguirre, one of the prominent men of the place, 
found it necessary to visit the coffee region adjacent to 
Champerico. On his arrival there he was attacked with per- 
nicious malarial fever, and died in four days. This fever, 
evidently of miasmatic origin, is called here amanllo or yel- 
low fever. The person attacked vomits violently, becomes 
intensely yellow, and as a rule, soon dies. These are the 
characteristic features of our Southern yellow fever, but as 
the disease is not contagious, and is often curable by large 
doses of quinine, physicians here do not regard it as identical 
with black vomit, or yellow fever. The experienced physi- 
cians of this country claim that they can nearly always cure 
the disease here, if they are called in time. Sometimes, 
however, the attack falls with such fulminating violence that 26 
S'l'ATk Mkiucai. Sm ikiv. 
no remedy can stay it. Such was the case of Aguirre. who 
died, though he had skilled medical service constantly at hi* 
side. Those persons whose business compels them to pass 
much time on the coast, as a rule, find immunity from dis- 
ease hy constantly using quinine. For this purpose, from 
eight to ten grains daily, should la? taken. 
The traveler here soon learns to duly appreciate the value 
of cinchona. Take away its alkaloid extract, quinine, and in 
less than two generations the low lands of Central America 
would relapse to barbarism; without this precious safeguard, 
steamship lines would never have been established here, nor 
would Northern engineers have been able to penetrate the 
tangled fastnesses of the dense woods, to survey routes for 
railroads. Hence medicine, in the discovery of the virtues 
of Peruvian hark, has contributed the most potent factor 
towards the advancement of civilization in these regions 
where nature so stoutly resists its progress. 11 umholdt. in 
his »* Ansichten der Natur.” shows that this discovery is 
wholly due to our profession; for instead of its la*ing an 
altoriginal remedy, he found in his travels among the Andes 
that the Indians, when attacked with fever, could not la* 
persuaded to take this Peruvian Imrk. 
As epidemic diseases, cholera and sinall-pox occasionally 
present themselves in Guatemala. In a village not far from 
the Capital, a few years ago, there was an invasion of cholera. 
As such a thing had hithertoo been unknown its appearance 
on this occasion was attributed to the foreigners having 
poisoned the water, and this belief took such strong hold of 
the native mind that several of the foreigners deemed it pru- 
dent to leave the place for a time. Sinall-pox, during my 
visit, was prevailing epidemically in some of the northern 
village**, yet owing to the medical profession encouraging 
vaccination, and likewise to the assistance rendered hy the Annual Address. 
27 
Government in the same direction, the disease was arrested. 
The advantages of vaccination have received further proof 
and illustration in this country. Among the Indians it is 
difficult to accomplish vaccination, the same prejudice exist- 
ing among them concerning it as one finds in certain places 
further north; hence where small-pox appears among the In- 
dians it is very fatal, while the most of foreigners fvho have 
been vaccinated escape the disease. Still, despite these plain 
facts, which are in accord with European and Mexican ex- 
perience, one finds in all parts of the world a few minds who 
will not accept them. xYs instances of such recalcitrant minds 
are Hammernjk of Vienna and Guerin of Paris. The former 
headed a deputation a few years ago that petitioned for the 
abolition of compulsory vaccination, while to-day the French 
Academy of Medicine often hears a harangue from Guerin 
against vaccination; and, true to his convictions, I saw that 
Guerin did not isolate small-pox patients from others in his 
wards, showing an indifference as though he thought that the 
disease was non-contagious. As analogues to these malcon- 
tents are those who claim that Shakespeare did not write his 
plays, who deny that Newton discovered the law of gravita- 
tion, or Harvey the circulation of the blood, or Columbus 
America. Such men would fain steer against the irresistible 
o 
stream of truth, and hope to gain notoriety from the conse- 
quent wreck of their puny barks. .Latin America, notwith- 
standing its intense devotion to orthodox medicine, has re- 
cently been favored with the advent of such an illy com- 
pounded genius, who indulges his pen in occasional diatribes 
against vaccination, and advises as a preventive to take ho- 
meopatliically prepared pillets of vacinia. Instead of going 
with the Vicar of Wakefield across lots to the church he 
would with the Vicar’s wife reach thither by a road three 
miles around—that is, on his wall-eyed infinitessimal colt 28 
State Medicai. Society. 
lie would reach the blood through the circuitous route of the 
stomach ami lsovels. Those who accept Hahnemann’s sacred 
Trilogy, that all existing disease originated in itch, barber’s 
itch or syphilis, will probably not find it hard to believe that 
the vaccine genus which are launched on this eventful pil- 
primage down their throats will la* lucky enough to find a 
point at which they can debark somewhere along the winding 
shores of the alimentary canal. 
Some years ago there was erected in the City of Guate- 
mala a monument to Jen tier’s discovery of vac- 
cination. Is it not an opprobrium to the north that only in 
this remote corner of the earth has there been just recogni- 
tion of this great discovery. 
A singular fact, ami which has been the subject of much 
study by Dr. Stoll, a very intelligent physician of Guate- 
mala, is that the art of mesmerism is known and practiced 
by the Indians of Guatemala. Dr. Stoll is preparing a work 
upon one of the Indian races here, in which this subject will 
l>e thoroughly treated of. This is another fact to la* added 
to those which Figuier has collected in his “ History of the 
Marvelous,” in which it is shown that sorcery, witchcraft, 
sonnamhulism, hypnotism, table-rapping and mesmerism art; 
branches of one common tree, in the trunk of which are 
bound up all the races of humanity. 
Among Americans who deserve special mention in connec- 
tion with the west coast of Central America, is Captain J. 
M. Dow. This gentleman, now agent of the Pacific Mail 
Steamship Com pany, at Panama, ala nit 1856 commanded the 
Columbus, a small steamer that made monthly voyages along 
the coast, stopping at the leading |s»rts. Through the intel- 
ligence and industry of Captain Dow, commercial relations 
were inaugurated with these States, which, small at first, have 
grown to large proportions, and have lieen the means of giv- 
ing to the Uunited States those advantages which England Annual Address. 
29 
has had the shrewdness to grasp and monopolize on the west 
coast of South America. As an example of the development 
of trade, may be mentioned that in the commencement the 
yearly amount of coffee exported from Guatemala was but 
thirty thousand sacks; now there are annually shipped three 
hundred thousand sacks. Besides his services to commerce, 
Captain Dow has made valuable contributions to natural 
science in the discovery of new species of plants, fishes, and 
animals. As an addition to botany, he has discovered in 
Costa Rica one of the most beautiful orchids of tropical 
America, which has been named after him by foreign scien- 
tific authorities. In the Gulf of Fonseca he has found a fish 
having four eyes, and which is viviparous; and finally, he has 
found a species of tapir previously unknown. Such work on 
the part of one so busily occupied with other matters so for- 
eign to scientific pursuits, is in the highest degree praise- 
worthy. His work has been duly recognized both at home 
and abroad. In England, where proper caution is exercised 
in awards to merit, he has been admitted to membership of 
one or more of the learned societies. 
This article would be incomplete without special mention 
of Dr. Fenner, who came from New Orleans to Guatemala a 
few years since, and through his high attainments in medi- 
cine has reached the first position in his profession. Besides 
being the consultant usually asked for where especial skill is 
required, Dr. Fenner has had the rare fortune to reach a near 
place to the government, so that no one is on more intimate 
terms than he with General Barrios—that remarkable man 
whose fearless heart, upright character, and unfaltering pat- 
riotism have safely conducted Guatemala through so many 
perils, and at this hour are causing most eyes to turn towards 
him as the one most competent to rule, in the event of these 
five republics entering into one common union.